Wednesday, August 19, 2009

Why I Support the Public Option

Recently, Randy Stapilus of Ridenbaugh Press had the following to say about the health care system in this country: "A gun is being pointed at your head, and mine, and everyone else’s, right now. They want your money or your life - if not today, then eventually." I, like Stapilus, have had a frustrating and frightening front row seat to an ineffective and colossally expensive health care system.

I have listened to the horror stories being told at town hall meetings across this country by real Americans, not raving right-wing protesters hell bent on disrupting and bringing to a halt a reform process that is a half century overdue. I have read hundreds of posts on blogs written by average Americans with anything but the average experience with this country's health care system. I have wondered quietly how politicians, especially Idaho's own first district representative Walt Minnick, can confidently contend that we need more competition in the insurance industry and that we need to treat government more like a business. I have contemplated the baseless argument that the government has no place in the health care system, while considering my own health care costs and the decisions I have been forced to make because I, like approximately 25 million Americans, am underinsured. Let me share a portion of my story as a way of illustrating exactly why I support health care reform and especially the public option.

For those of you who know me and those who have followed this blog for more than a year, you know that a year ago this September I had spinal surgery. As early as the fall of 2007, I was experiencing stiffness and discomfort in my lower back. By February of 2008, I was starting my mornings with stretches to get my body in a fully upright position. In mid-February, I woke up in a hotel room in Boise with a great deal of pain and stiffness in my back. After the three hour car ride home, I was unable to lay down flat and was experiencing numbness in my legs. When doing stretches that had been suggested to me by my doctor in the past did nothing to relieve the pain or stiffness, I finally approached my doctor in May of last year and explained that I was having trouble riding my bicycle because my left hamstring and glute were too painful and a large portion of my calf and foot were completely numb. I began physical therapy immediately and an MRI revealed a herniated disc and an entrapped nerve. Aggressive physical therapy, epidural lumbar injections, and oral steroids did nothing to relieve the pain and numbness. By the end of the summer, I had lost complete feeling in my left foot and a majority of my left leg, I was unable to place weight on my left side without shooting pain, and numerous other anatomical structures were not working properly. I had what they call open back surgery in September, which included the cutting and pulling back of muscle, removal of a section of the vertebrae, removal of the disc, and spinal decompression.

When I first began seeking treatment for my back, I was still paying for health care costs incurred in the Spring of 2007. Both now and then, I was insured through a student health insurer. Even when I was working full-time and going to school, the small business I was working for did not offer benefits. Because of a pre-existing condition and other health circumstances I was actively being treated for, two years ago it was necessary for me to be insured through the student health plan because I couldn't afford insurance elsewhere. Now it is necessary for me to be enrolled in the student plan, thus also enrolled in school, because no other insurance company will cover me.

Despite being insured, something I am incredibly grateful for, I continue to pay sky high, out-of-pocket expenses that my insurance will not cover. Over the past 22-month period, I paid $4740 out-of-pocket for basic health care services (e.g. prescription drugs, blood work, x-rays, and office visits). This cost does not include surgery or surgery-related expenses, outpatient procedures, or physical therapy. I estimate that of those costs, $2370 of it was strictly for prescription drugs which my insurance does not cover, but I am able to get at a discounted rate here on campus.

None of these costs I have listed include my health insurance premiums. For the 2007-2008 academic year, my health insurance premium was $1046. The premium remained at that cost for the 2008-2009 academic year. The premium this year (2009-2010) will be $647 per semester, $1294 total. In 2008, my health insurance premiums alone cost me 11% of my income. Another 14% of my annual income went to prescription drug costs. If I combine the cost of my premiums with my prescription drug costs, 25% of my annual income went toward preventative care and maintenance. Estimated surgical and out-patient expenses for 2008, minus the actual spinal surgery and associated costs, ate up another 70% of my income. Yes, from January through August health care cost me 95% of my income. If I were to add the costs of surgery and out-patient procedures, I wouldn't be surprised if health care cost more than double what I made last year. And this is for someone insured.

The amount I have shelled out since September of 2008 for MRIs, spinal surgery, out-patient procedures, and other medical expenses that do not fit into the basic categories (office visits, blood work, x-rays, and prescription drugs) already far exceed my adjusted gross income for 2008. I am making significantly less money than I did in 2008, both because I took a pay cut to keep my job and because my productivity level has decreased as my health has waned.

When I began college in 2003, the cost of student health insurance for a semester was $275. Student health insurance now costs $647 per semester. In six years, the student health plan has not only increased 235% per semester, it has been underwritten by at least two different insurance companies. The current plan has a ceiling on payments per illness and it wouldn't surprise me if I wasn't nearing that cap as well given the costs of surgery, treatments, and physical therapy (my plan pays 100% of physical therapy costs at a pre-specified clinic and I have had nearly 120 sessions of p.t.).

Uninsured and underinsured Americans are either going without needed medical services/treatments or they are having to pick and choose which treatment they an afford. For instance, my health insurance does not cover dental or vision. I pay out of my own pocket for the eye exams my health history requires--an exam every 6 months and usually new corrective lenses each time. I do not go to the dentist or at least haven't in six years. Surely other Americans pick and choose which treatments, exams, medications they need. We shouldn't have to, but we do.

The uninsured and underinsured are not only compromising their health by having to pick and choose or go without treatments, they are facing financial demise and often bankruptcy. I was fortunate to have around $5,000 in my savings account when I started having back problems last year. I had been saving money steadily to help pay for the costs of graduate school. Since I started having back problems, I have completely emptied out my savings account and racked up substantial credit card debt. And because student health insurance is the only insurance that will cover me (I am not eligible for Medicaid and the only private insurer that will cover me requires a $7,500 deductible and monthly premiums around $300), I have had to take out large student loans to keep me enrolled in school and this particular health plan until I am either able to afford private insurance or can get a full-time job with benefits that will cover me despite pre-existing conditions.

I don't enjoy talking about my personal finances or my health, but when I hear pundits like Glenn Beck say we have the greatest health care system in the world and I know I'll be paying for the last 22-months of my life for years to come and I still can't get all of the medical care I need, it makes me furious. I am embarrassed to admit that I went to that financial edge and teetered for awhile, to that place where so many Americans are with mere pennies to their name, mountains of debt, and bills stacked up. I've come back from that edge, at least in the sense that I am surviving with more than $3 in my checking account (though debt in the tens of thousands), and I still don't know if I am out of the woods and sure to not travel the road to that particular edge again.

It makes me incredibly angry when I hear politicians like Walt Minnick (D-Idaho) say that the answer to the health care crisis is to create more competition in the private sector while keeping the government out of the health care business. There are how many health insurers in this country right now? I am still uninsurable! Competition isn't going to help me and a whole hell of a lot of other Idahoans.

Frankly, when I hear those conservative blowhards in Washington (you know, the ones Minnick ideologically aligns with) spout their fears of a "government takeover" I want to ask them why they oppose a government takeover of health care but have supported the takeover of this country by the insurance industry and other corporate interests. It certainly isn't because they fear government being bought, after all these congressmen have been bankrolled by the insurance industry for decades.

We need a public option that does not discriminate based on pre-existing conditions, sex, or age. We need a public option that is affordable, one that will ensure that our entire life savings is protected should we get sick. I, for one, am mad as hell that I will live most of my life in debt because when I was twenty-three years old I needed spinal surgery and I had health insurance. I'd say I can't imagine how the uninsured do it, but I was uninsured for most of my childhood and understand intimately. Every member of Congress, enlisted soldier, and eligible senior citizen takes advantage of a government-run health care system that is highly effective. Why can't the rest of us?


Anonymous said...

I am so angry that you are having to go through this. I am having similar issues with health costs for medical conditions and I think it's criminal that our country, and many of our fellow Idahoans, think that good preventive health care is a privilege and not a basic human necessity.

You are in my thoughts.


Tara A. Rowe said...

Thanks, Nemesis. As I pointed out, things are getting better. Financially at least. My health remains a battle.

Jessica said...

I am so sorry. And I am sorry that we potentially have a President and many in Congress whose only answer is co-ops because they care more about getting reelected than serving the American people.

Sisyphus said...

Did you see this?

Joseph Martini said...

As a New York State resident I am prohibited from choosing a high-deductible insurance plan. Forced by the state into a comprehensive benefits program I'm compelled to pay more than $14,000 per year to protect my family from financial ruin caused by a serious medical condition. I'd choose your plan over mine any day.